High-Sensitivity Cardiac Troponin I Predicts Occult Coronary Plaque Burden in RA

Plasma high-sensitivity cardiac troponin I is associated with occult coronary plaque burden and cardiovascular events in patients with rheumatoid arthritis, according to results published in Rheumatology.

Patients with rheumatoid arthritis who had low high-sensitivity cardiac troponin I levels had a lower risk for extensive atherosclerosis and cardiovascular events.

High-sensitivity cardiac troponin I may allow clinicians to optimize cardiovascular risk stratification for patients with rheumatoid arthritis.

The study included 150 participants who were evaluated with 64-slice coronary CT angiography. The researchers assessed coronary artery calcium, number of segments with plaque (segment involvement score), stenotic severity, and plaque burden, as well as blood levels of high-sensitivity cardiac troponin I and proinflammatory cytokines. Participants were followed for 60 months for ischemic and nonischemic cardiovascular events.

After analysis, the researchers found that plasma high-sensitivity cardiac troponin I correlated with all coronary plaque outcomes (P <.01). Elevated high-sensitivity cardiac troponin I (≥1.5pg/mL) was associated with significant calcification, extensive atherosclerosis, obstructive plaque, and any advanced mixed or calcified plaques after adjustments for cardiac risk factors or Framingham D’Agostino scores (all P <.05).

During follow up, 11 participants experienced a cardiovascular event (1.54 per 100 patient-years), 8 of which were ischemic and 3 of which were nonischemic.

Elevated high-sensitivity cardiac troponin I level predicted all cardiovascular event risk independent of demographics, cardiac risk factors, and prednisone use (P =.03).

Participants with low high-sensitivity cardiac troponin I level had a lower risk for both extensive atherosclerosis (P <.05) and incident cardiovascular events (P =.037).

Reference

Karpouzas GA, Estis J, Rezaeian P, Todd J, Budoff MJ. High-sensitivity cardiac troponin I is a biomarker for occult coronary plaque burden and cardiovascular events in patients with rheumatoid arthritis [published online March 14, 2018]. Rheumatology (Oxford). doi:10.1093/rheumatology/key057